MONTGOMERY, Ala. — Alabama health leaders urged action Wednesday during a legislative panel on addressing the state’s struggling health care system, which one panelist described as being in crisis.
“We have a health care issue in Alabama; our life expectancy is shorter, and not only that, we spend more years sick,” said Amanda Williams, former president of the Medical Association of the State of Alabama. “… Right now, our health care system is in a crisis.”
Williams was one of three panelists featured at the Alabama Daily News Legislative Breakfast Series, with Wednesday’s event focusing on health care.
The event was kicked off by Teresa Shufflebarger of UAB Medical Center, who also leads the university’s health initiative Live HealthSmart Alabama. Through the more than 5,000 free health screenings conducted across the state by Live HealthSmart since 2021, Shufflebarger said around 80% of people fell outside the normal range for various health metrics such as blood pressure and blood sugar levels.
Shufflebarger also said that a significant share of Alabamians screened also suffered from untreated and previously undiagnosed chronic disease, painting an even bleaker picture of the state of Alabama’s health care system.
“So 7% of those screened had high blood pressure and they didn’t know it; 4% had diabetes and they didn’t know it,” Shufflebarger said. “More concerning (is that) 11% of those screened had high blood pressure, they know it, and they’re not doing anything about it. That is a stroke that shows up in our hospitals that shouldn’t be there.”
A fifth of those screened had untreated diabetes, Shufflebarger said, who went on to stress the need to help provide access to preventative care for Alabamians, insured or not, with about 421,000 residents without any form of health insurance as of 2022.
“What our rural hospitals and providers need is a larger insured population is one thing, but (another thing they need is) to be able to have a focus on preventive care,” she said. “Not just a focus, but for us as a state to find a way to support preventive care, and that means pay for it.”
When asked by ADN’s Todd Stacy to describe the health care ‘crisis’ from the perspective of a health care provider, Williams, who is also a Montgomery-based physician, listed a number of issues plaguing the state that have contributed to its poor health outcomes, including low physician reimbursement rates and cases of malpractice.
“Physician reimbursement rates have gone down tremendously, it makes it very hard to recruit physicians here when they can go a couple hours away and make substantially more and see significantly less patients,” Williams said.
“The other big problem that we have in Alabama is our malpractice environment. We are now considered one of the worst states to practice medicine because of the number of what we call nuclear verdicts, or juries who have made a verdict over $10 million, so those have gone up and up and the cost of malpractice insurance has gotten tremendous.”
On costs incurred by the state from its struggling health care system, Shufflebarger said that the total economic impact of chronic illness in Alabama was $60.2 billion annually, according to a 2020 report from the Milken Institute.
Rep. Paul Lee, R-Dothan, also participated in the panel discussion, and told Stacy and attendees that lawmakers were currently working to address what is known as the “coverage gap,” the hundreds of thousands of Alabamians who make too much to be eligible for health insurance subsidies through the Affordable Care Act, but too little to afford health insurance on the private market.
Lawmakers explored the idea of expanding Medicaid last year through a private-public partnership model, going as far as to hold meetings with lawmakers from other states that had expanded their own Medicaid programs to discuss the pros and cons. Republican lawmakers ultimately decided against pursuing Medicaid expansion, something Democrats have championed for years.
Lee said Medicaid expansion plans were “on hold at the moment,” but that lawmakers were still actively working to address the shortfalls in the state’s health care system. Stacy asked Lee if, much like Gov. Kay Ivey’s Safe Alabama or Be Linked Alabama initiatives to improve public safety and expand broadband access, respectively, state leaders would consider a similar initiative to improve Alabamians’ health.
“I think that’s very possible,” Lee said. “I think that, as we’re seeing our budgets tighten up, we’re going to see the value of – and some people in here may take this wrong – the business side of it. Forget the health, the business side of it and the health part of it work together.”